I can stand all day (although these days I do a fair bit of standing all night at the local pub ).

One thing that has been a bit of a surprise is that I think my inability to walk or even look after myself for the first 4-6 months of my L4 L5 disc herniation took a toll on my 10 year relationship… yes I’m riding solo for the first time since I was 17.. weird!

My partner gave 100% attention and care during the whole episode, and was very supportive (which I’ve explained in previous posts), I just started getting normal again when the bombshell dropped, and I think it was to do with the fact that our relationship had turned slightly into a carers relationship. She looked after the house, paid the bills etc etc, although things were on the way up with me getting back to normal I think it just took it’s toll. There are obviously other factors, but I think it was a reasonable contributor… all credit to her for sticking with me while I was in the worst state…. I couldn’t have done it without her.

Back to the update. If I stand for a day, or night, what I notice is when I go to bed is a slight stiffness, but by the time I wake up in the morning I’m back to normal. I wouldn’t be surprised if it’s to do with muscle strength, which is again is getting better and better as I go on.

The surgeon seems to think that the nerve simple broke free from where it was attached to the disc…. He likened it to a tree that has been cut and sap comes out.. same with the disc.. and the sap basically goes like glue, the nerve is right there, it sticks, and stops moving. You get the nerve trying to move over the disc, it can’t, it irritates it, and gets inflammed. The inflammation has no where to go because it’s all compacted in with the ejected disc material.

So, one day, I bent funny, or moved, the nerve came free. It took a few months to get 99.9%, but within the first week it was 80% better, which is amazing considering it completely ruined my life for 18 months, and in a snap it was better. I’m very thankful.

Most people who are going to getter better without surgery do so within the 3 month timeline. Less at 12 months, and very few at 18 months…. but I’m glad I waited… although at 18 months I was ready to have the operation.. Infact in the last few posts I can’t remember if I said that I had actually thrown the towel in. I had seen the surgeon, and been sent for 1 more MRI to form the basis of the operation. It was between having the MRI and going back to see the surgeon to book the surgery that it came good… How lucky was that!

I’ll keep posting, but less regularly.

Best of luck.

I do get notifications of comments, and I do still reply to all emails, so keep on commenting, and emailing me.. Happy to discuss. matt@mylifemytravel.com

Cheers
Matt

When I cast my mind back to my deepest and worst times with my herniated disc and sciatic leg pain, all I can remember is a fuzz (primarily due to pain killers). Basically the most I did during the day was write an entry on the blog, eat something small, and watch a bit of TV or a few movies.

The problem was the pain killers were so strong, I was in a haze.

However over time you get the pain under control, you start getting a little more comfortable, reducing the pain meds and basically you start getting really bored. My partner had to keep working to earn the cash to pay the bills, so that left me a lotta time to fill.

You can’t go for a walk, you can’t do much in the house, so you have the internet, movies, tv, books and magazines.

I stumbled on to something recently that I wished I had during those times to pass many of the boring hours, and although I don’t want to turn this into an IT techie blog I feel that my experience with this insane world changing technology was worth sharing for anyone who is stuck at home, needs to keep themselves connected to the world and needs to keep occupied if they’ve got niggling pain.

An amazing friend of mine bought me an Amazon Kindle (Kindle: Amazon’s New Wireless Reading Device). My next question was “what the hell is it”… it’s simple. It’s a screen that resembles ink on a page.

It’s linked to Amazon, and it allows you to buy books, newspapers, everything.
The battery life lasts about 8 days for me (wow), less if you have the wireless on (about 3, but who leaves it on). It weights about 10 ounces (about 0.29KG), so it’s easy to hold and read (long into the day and night), and comes with inbuilt wireless (apparently the same as your mobile phone, but doesn’t cost a cent!) which is awesome because you don’t need to hook it up to a computer, and you don’t need your own wireless internet! I know, wow!

So, the best things on the device for me are the books. They’re cheaper than buying the actual book, and after watching TV shows (no I don’t watch Oprah, okay, sometimes I do) you can download the book and get cracking right when you have the inspiration.The 1 downside is the cost. At around $399US I think it was worth every penny, I guess it comes down to where you are financially and what your sanity is worth Fortunately I had a friend gift it, but if you want to give your family something to contribute to, I think it’s worth it – assuming everyone has read this post in particular tip number 11, and now owns a cold pack and uses it regularly!

Anyone watch the movie Jane Austen book club.. me neither, damn it, okay, I did, but I was forced. Well if you got inspired to start a book club, I recommend everyone getting one of these puppies. Also good for bed gatherings with family for a laugh!

There is a promo video on the site (here), which basically tells it like it is, and more interestingly it seems that there are ways you can check your email over the Kindle, and I’m sure there is more to come.. so convenient, small and light…

lastly, they’re not joking when it says it looks like ink.. it really does.

Unfortunately, now I’m back in Australia it doesn’t work – ie I can’t download anything through the wireless – targeted for US market. However, I can through USB.

For all US readers, well you’re in luck and hopefully in range. I think I’ve already mentioned it, but the books to buy through this device are more than half price… I’m not sure how long that will last, but it is awesome.

This is about one of the only pieces of technology, asides from an iPod I think I’ll recommend on the blog. But trust me, it’s worth it.

Check it out:
Click Here

Cheers
Matt

Things I think anyone stuck at home with a bad back should have:

8GB iPod Nano …….. Amazon Kindle ………. Back Pain Books ……

For everyone landing on this blogs home page, it can be difficult to find the great stuff from the good stuff especially if you’re pressed for time, that’s what I like to think anyway.

So a friend of mine who is a guru on Google analytics has given me the top 3 posts on this blog by sheer number of visitors. If there are other posts you think are valuable or have been helpful please let me know through the comments on this post and I’ll create a most recommended posts post (if that makes sense).

Besides the home page the most viewed posts on the bad back blog are (drum roll):
# 1 l4-l5-herniated-disc-back-pain-update-7 More than double the hits of any other post
# 2 l4-l5-herniated-disc-back-pain-update-9-2
# 3 10-things-you-should-try-before-back-surgery

Cheers
Matt

Well things are improving for me. It’s a good news story here so far, and if you’re suffering I know it’s hard to read someone else’s good luck story. I know I hated it, as in I was wishing I would be miraculously be cured.

Basically day to day I’m noticing small improvements. For instance I’ll be walking and slightly jump over a pot hole in the road or something, and for the first time in almost 2 years I jumped over one and didn’t think anything of it… then as I walked away I thought that’s the first time I’ve done that and didn’t have the thought before, during or after that I had leg pain. Very nice.

I’m basically focusing on losing a few kilograms (pounds) to make sure I don’t ever have a reoccurance, because the thought of that leg pain again would drive me over the edge… I’d probably be in the queue for surgery within weeks….

I’m starting to question my job a lot more, and starting to think what to do with my life… previously when my back/leg was really bad I felt I had to take shit at work to make sure I never lost my job.. it was my security.. basically who’s going to employe someone who limps in on a walking cane, can’t really travel… well I’m sure there are employers that would look beyond that, but none the less it makes it more difficult.. even for me.. having to go to interviews with major back pain, not being able to concentrate etc etc.

Also, I’ve got the report from the MRI here, and I’ll type it out in full.. it’s an interesting, slightly depressing read, however you need to know for the last 3 months I’m basically living a normal life without pain… here goes:

MRI THORACIC & LUMBAR SPINE (VISIT 2)
Clinical Notes:
A 28 year old presents with ongoing left leg pain. Also interscapular pain.

Report:

T5/6:
There is moderate disc degeneration. Schmorl’s nodes are present. A focal right paracentral disc protrusion is evident indenting the cord. The cord contains no abnormal signal.

T6/7:
There is mild wedging of the T6 vertebral body. Schmorl’s nodes are evident and there is some endplate irregularity. A focal central disc protrusion is present mildly indenting the anterior aspect of the cord.

T8/9:
There is mdoerate disc degeneration. A central and left paracentral disc extrusion has been shown. The extruded component extends a short distance cranially. The extruded disc lies just anterior to the cord minimally indenting its most anterior margin.

There is a moderate kyphosis in the mid aspect of the thoracic spine. There is a tiny disc bulge at T2/3 and also at T1/2. The other thoracic discs are unremarkable. The thoracic cord is intact throughout with no syrinx formation. The conus lies at T12/L1 and is normal.

L4/5:
There is a large left posterolateral and foraminal disc protrusion. The disc touches the adjacent facet joint compressing the traversing left L5 nerve root. The exiting left L4 nerve root is not compromised. The right exit foramen is adequate.

A shallow annulus bulge is present at L3/4 without neural compromise. The other lumbar discs have retained their normal height and contour. Lumbar face joints are well maintained. Paraspinal muslces are well preserved.

On the sagittal T2 images there is the suggestion of tiny nodules in relation to the cauda equina. These measure up to 2mm in size. These are felt to be of low grade significance. I cannot identify these foci on the axial scans. At most, they could represent small fibromas in relation to the cauda equina.

A tiny right paracentral disc bulge is present at T11/12.

Comment:
1. Scheuermann’s change affects the mid thoracic spine with multiple endplate irregularity and multiple adjacent disc protrusions. Many of these indent the cord.
2. Left sided disc protrusion at L4/5 compressing the left L5 nerve root.
3. Tiny nodules in relation to the cauda equina and lumbar spine. These nodules were present on a prior study from 6/6/2006 and are unchanged. The left L4/5 disc protrusion has increased significantly in size.

END OF REPORT.

So basically, I have a L4L5 disc bulge, I had Scheuermann’s disease as a teenager.. which from what I’ve researched can happen to anybody, and in many cases goes undiagnosed, and basically can’t be treated. Everything else I think is just normal bullshit… that’s my understanding.

In any case it’s hard to type this and read it, because you always feel like your body is kind of like your temple.. that pretty much everything is okay, and you feel okay etc etc.. but reading this makes you realise life is short.. live it.

Cheers
Matt

So it’s been over a month since the last post.

To summarise (well a verbose summary?):

I’ve waited 18 months and tried various different treatments for my herniated disc at L4-L5.
I’ve finally given up the wait, and the cost of trying to treat it without surgery.
I cracked the shits and booked in to see the surgeon (Gary Speck).

We agreed that this situation although not doing any nerve damage isn’t really a way of living.

I booked in a week later to have an MRI so that the surgeon could plan the operation from a current MRI.

The MRI goes fine, however the day after I notice some of the pain is starting to subside… and frankly it’s pissing me off.. because I just want it to be bad enough that I can justify the scary surgery.

Again the next day it’s getting better.

I go back a week later, and see the surgeon to discuss the MRI, and basically book in the operation.

I sit down, he asks how’s it going? and I say would you believe I think it’s getting better. After 18 months of no break throughs he kinda looks at me as if I’m getting nervous and trying to justify my way out of the operation.

Anyhow, we’re about a month out from that meeting, and my walking has returned to normal !!!!

I have gone from walking at most a few minutes and then having to squat or sit, to I just walked 5km down the beach without stopping or thinking about my back or leg pain… !

So, I know there will be people who read this and think is this a con job? or is he bullshitting? or gee that won’t work for me… and you maybe right on the last point.

However after 18 months, every specialist said I wouldn’t get better, and I should be operated on… holding on for 18 months seems to have paid off BIG time.

Anyhow, I’m basically pain free, and walking. I’ve got odd pains every now and then if I twist at a weird angle, or if I’m in a weird angled seat.. but other than that.. all good.

I’m not sure I’ll go back to snow skiing as the pain was so bad, I want to do avoid anything that will give me that sort of pain again.. but slowly but surely life is returning to normal.

For instance, I notice I’m reading magazines when I stand at the checkout counter at the supermarket because I’m not dieing with leg pain, and wanting to get back to my car asap so I can sit down.

Stuff like that.. it’s insane… in a good way, but it shows me how much I’d given up, how much suffering I’d gone through for 18 months.

So, I’ll continue to give updates on the blog, but expect them to be fewer and farther apart as I start to explore life again.

Thanks for all the support.

Cheers
Matt

Tags: L4L5, L4-L5, L4/L5, herniated, disc, herniation, bulging, disk, buldging, ruptured, rupture

The MRI just taken compared to almost 18 months ago still shows the herniated disc.

The doctor said it’s the same if not worse than what it was originally… although we both knew that it got much worse after the first MRI, so who knows how bad it actually was to compared to what it is now.

I’ve also had upper back pain since I was a teenager, so in the last MRI I got them to do my thorasic spine as well (which is middle to upper part of your back).

It turns out (and unrelated to the herniated disc) that when I was young I had/got Scheuermann’s disease (also know as Sherman’s disease).

Basically it’s where the discs rupture, but instead of bulging outwards into the spinal canal they bulge into the vertebrae.. so basically it doesn’t affect the nerves, just the bone.. technically there really isn’t any pain associated with that, but what it does do is curve the spine, and in some people really severely, this then causes fatigue in your back muscles which gives the dull ache, which is what I’ve got… after the age of 20 or so (and I’m almost 30) it’s basically all over.. it doesn’t get worse or better.. and theres no real treatment for it (except for the usual get fit, be health, don’t smoke).

So back to the herniated disc at L4-5… There is no difference, and the crux of the whole thing is this:

I can have the operation and the surgeon thinks a successful outcome sits in the vicinity of about 90-95%. However the 10-5% is bad… things like lose of bladder control, nerve damage, nerve scarring etc etc.

So the question you have to ask yourself is: can I live like this for ever, or have I 100% absolutely had enough, and I won’t regret the operation even if it turns out badly… that’s it.

So now I’ve got to decide if my current issues/problems are enough to say “you know what, I’ve honestly had enough of this entire frigging thing, I want out”, or “you know what, this is bad, but honestly I can live through it and deal with it, and frankly many have it worse, and I should be grateful for what I’ve got and can do”.

At the moment I’m leaning towards the operation but it changes every other day. I’ve set a date for Feb 08 for the operation, which gives me a bit more time to think about my options.

If I have the operation I’ll be out of work for 3 – 8 weeks.. and it’s basically personal preference how long I have off… i need at least 3 weeks, and if I want to build my muscle core back up and go back to work better than when I left I should give myself the 8 weeks.

So that’s it.

I’ll scan in the MRI when I’m near a decent scanner in the next few days/weeks.. it’s interesting to see the actual bulge, and the other issues in my upper back.

I’ve also got more reading material on the operation, and the issues that can arise, so when I get a chance I’ll transcribe those down.. you can compare notes with what your surgeon gives you.

Cheers
Matt

Tags: l4, l5, herniated-disc, herniated, disc, l4-l5, bulging-disc, bulging, buldging, buldge, bulge, slipped-disc, slipped, l4l5, l4-5, ruptured, protrusion, protruded, slipped, slipped-dsic, treatments, treatment, replacement, disc-replacement, biomechanics, spondylolysthesis, spondylolisthesis, discectomy, degenerative

I was in the beast for about 25 minutes, and it’s seriously hard to control your breathing. The noises are intense, and because you’re blind folded and in a small place your really notice everything.. like the wind blowing on your nose etc etc.

Everything feels like it needs a scratch because you know you can’t move to scratch it!

Anyhow it’s all done, not much else is news, I’ll post again after I’ve got the results of the MRI and what the plan is for the surgery.

I meet with the surgeon about the laminectomy towards the end of this week.

So stay tuned.

Cheers
Matt

My brother is extremely sick and he’s currently back packing his way through Europe.

A few hours after getting the call I was on an aeroplane flying to Holland. It was close to a 40 hour trip, so from Melbourne it was about 8 hours to Hong Kong, a few hours changing planes, then 22 hrs to London (Heathrow airport) a few hours changing planes, and then just over an hour to Holland.

So, you’ve got a herniated disc, radiating leg pain and you HAVE to travel.. this could be a NIGHTMARE.

First thing, go to the doctors. Organise pain medication (I’m currently using digestics, which are a lot better than codine or panadine forte’s ‘etc). Get anti-inflammatories (again I use mobic), and get some valium if you need it (be careful some countries like Greece treat Valium as an illegal substance). When you go the drug store (pharmacy/chemist) make sure you get some vitamins for cramping etc (I found this out the hard way, I got there, and woke up in the middle of the night with lower back cramps, that give me the worst leg pain, and even cramps in my calf and foot). Make sure you have enough ‘drugs’ for the whole trip, you don’t want to be visiting the doctors in foreign countries and trying to fill prescriptions for drugs (it could also be really expensive).

Make sure when you touch down at your destination you get a few bananas, these really help because of the potassium (I think) in the banana.

Also, make sure you WEAR your back brace, if you don’t have one, get one!

It’s tempting to drink the free booze (alcohol) but again try not to, it’ll dehydrate you and make the disc space even smaller, try to drink as much water as possible. Again, try to avoid the coffee as well, or at least don’t have a cup every time they offer it

Bike riding! Well Holland is famous for the amount of bikes here, and I’ve now been riding the bike for a few weeks, and I can tell you it’s the best thing I’ve done in 12 months. Walking for me is restricted to 5-10 minutes as the pain in my leg gets really bad, I can sit all day not a problem.. but walking is a real pain…. riding a bike gives me no pain, and gives me all the freedom in the world to venture out and take in the sights, sounds and smells of the city, something I’ve missed for the last 12-18 months.. I’m loving it.. and I’ve had no negative affects afterwards. No extra pain, nothing.. if anything it’s helping with the muscles etc, and helping me lose a bit of weight

One last thing… I found these heat packs at our local markets.. they’re very strange, but very useful. You boil the heat pack.. and then let it cool down.. until it goes to room temperature. You wrap it up in the cloth they give you.. and forget about it. If you are out and about and would enjoy a heat pad, basically you unwrap it, and shake it.. it starts emitting heat like crazy. Apply it to your back (or wherever). The heat lasts for about 20 minutes.

Then to ‘recharge’ it you boil it again, and let it rest… and repeat over and over, I’ve probably done it to mine a few hundred times, and it just works… boiling it must somehow reverse the chemical reaction until next time you shake it… then hey presto, you’ve got a heat pad on a plane 10 hrs into a flight… magic!

The last thing, I bought a squidgy neck pillow, it’s awesome cause you can squeeze it anywhere. So I used it as a lumbar pillow, to sleep on, to put under a leg.. whatever I needed to get comfortable.. awesome!

That’s it.

Cheerio
Matt

Tags: l4, l5, herniated-disc, herniated, disc, l4-l5, bulging-disc, bulging, buldging, buldge, bulge, slipped-disc, slipped, l4l5, l4-5, ruptured, protrusion, protruded, slipped, slipped-dsic, treatments, treatment, replacement, disc-replacement, biomechanics, spondylolysthesis, spondylolisthesis, discectomy, degenerative, diet, anti, inflammatory, anti-inflammatory, travelling, with, a, bad, back, travel

Well again it’s been a while since I’ve given an update of my herniated disc and sciatic leg pain, and the last few months have been a huge roller coaster ride again.

Basically earlier this year I had a few slight improvements, as in the pain went away when I’m sitting, and there has been significantly less pain while walking within a 5 minute time span. I still suffer excruciating leg pain if I go for more than 5 minutes, but it resets itself if I sit or squat for about 30 seconds.

Basically I’ve been toying with the idea of surgery for a while, and you can see a page I put up (link in the right hand panel)… basically there are a few video’s off of youtube of back surgery, and one of the interesting ones is a new minimally invasive discectomy.

Anyhow, I made an appointment (for Sept 07) with my orthopedic surgeon (Gary Speck – Melbourne, Victoria), and had pretty much resigned to the fact that the residual pain I had left was going to be resolved by surgery.

In the meantime I’ve continued to have treatment on a cox bed (www.coxtechnic.com) anywhere from twice a week to once a fortnight.

Then about 2 weeks ago something changed. I’m not sure what it was, but something has changed. My walking within a 5 minute timeframe is completely normal, and the pain in my leg after 5 minutes seems to be diminishing day by day.

I still have a bit of pain if I move in weird positions etc, but in bed there’s no pain, I can sleep with my legs straight !!!!!

Basically I’m starting to feel a lot more normal.

Now before I get carried away, I’ve had similar periods like this where I thought I was getting better, and then it gets worse again, I’ve said before, the whole condition comes and goes in waves… in the early days the waves were in hours…a few hours of terribleness, and a few hours of thinking I’m getting better. Over the last 12 months the cycles have become longer, for instance I’ll have a day of goodness, and a week of not so goodness.

And I think recently I’ve been in waves that are lasting weeks or months, and that’s where I’d resigned to the fact I needed surgery. But now there’s a bit more light at the end of the tunnel.

So I’m still going to go through with the appointment in September and get the surgeons opinion, and I’m guessing I’ll have another MRI….. is anyone interested in seeing my initial scan 12 months ago, and the new one (post a comment if you are)?

I’m really hoping that over the course of the 12 months the disc buldge has reduced, and with the continued use of the cox bed it’s relieved the pressure off of my nerve.

I still continue to take some anti-inflammatory medication, in my case it’s Mobic 15 mg.

I’ve experimented again with Voltaren (it’s cheaper) to see how it went, but again it really upsets my stomach, although I must admit I felt it did a pretty good job on reducing the amount of pain in my leg (ie reducing inflammation in my back).

As the amount of pressure reduces on my nerve I feel the pain changes in my leg. I get less pain radiating down my leg, and every now and then I get a tingle in my toes etc. I’m also finding I’m starting to get a bit more muscle spasm in my lower back. The secret here is having a good anti-inflammatory heat rub – I’ve got something called axe oil that seems to do the job nicely. Having someone to rub it in, and rub the muscles also helps BIG time. If you don’t have someone who can rub it in for you, pay for it… it’s worth it.

When it gets bad I continue to use the heat pads, and ice packs, although I must admit I use it a lot less from when I first started. When I first got the pain I used a heat pad that made it worse, again, when you first get back/leg pain use ice packs only. for the first week or 2, then slowly move to using heat and cold.

These days because it’s more muscular I tend just to use heat.

I’m completely off of the walking cane, and I think that was a big thing for me heading in the right direction. I started to limp less, the antalgic lean is completely gone, although I always worry if I’m on public transport etc that nobody is going to give me a seat cause they don’t think I’ve got a ‘condition’…. the cane was really good at showing people you have a condition, and they’d happily give up a seat for you… normally you didn’t even have to ask.

As I do a bit more walking I notice I get a bit more upper back pain, but part of that is just endurance.. my upper back hasn’t had to support me standing up for more than a few minutes in the last year. So it’s to be expected… some basic gym work will fix that up, along with a good massage

So I’ve got my back surgeon appointment in a few weeks, and I’ll give you an update then.

Cheers
Matt

Tags: herniated, disc, l4, l5, l4-5, l45, l4l5, buldging, buldge, bulge, bulging, protruded, protrusion, ruptured

I wanted to add that a diet, or at least food moderation is really important when you have a herniated disc, because generally when you get a bulging disc your ability to exercise (even normal activities) are severely reduced.

In my case I can’t walk for more than about 5 minutes without pain, so guess what, I don’t walk a great deal. I’ll get a taxi if it’s more than 2 city blocks (taxi drivers hate me).

Also at home, the amount of activity I do is greatly reduced… house work, gardening etc etc it’s all put on the back burner (no pun intended).

So although I don’t recommend a diet per say I definitely recommend that you are aware of your eating habits. Make every meal a maximum size of your fist (you remember those old rules). Eat regularly, but don’t over eat, the moment you do your body starts packing it away and you don’t really have the ability to lose the weight. Also, as all herniated disc sufferers would know the more weight you carry the worse the condition, and also the chance of herniating another disc or make the one you’ve already got worse is greatly increased every single kilo/pound you gain. The reverse is also true, so actually losing weight (from when you herniated your disc) is amazing if you can achieve it…. to date I seem to have plateaued… it’s hard I know!

Also, if you’re thinking about surgery, you really want to reduce your weight because during the operation they actually pierce the annulus (outer casing of the disc), and any extra weight can push new disc material out again. (watch what they do during a back surgery)

So again, I don’t want to harp on this, but do everything you can to reduce your fat intake, and limit the size of the meals. The fatter you get with this condition the worse you are.. and I know how hard it is… you’re sitting around home, with a bad back, can’t work, can’t do much of anything, food starts looking like the perfect accompaniment to a good session of Oprah or Dr Phil

Please add your comment if you’ve got any TIPS for other readers.

Cheers
Matt

Tags: l4, l5, herniated-disc, herniated, disc, l4-l5, bulging-disc, bulging, buldging, buldge, bulge, slipped-disc, slipped, l4l5, l4-5, ruptured, protrusion, protruded, slipped, slipped-dsic, treatments, treatment, replacement, disc-replacement, biomechanics, spondylolysthesis, spondylolisthesis, discectomy, degenerative, diet, anti, inflammatory, anti-inflammatory

This is probably a pointless sentence, but just in-case, we want an anti-inflammatory affect from our diet to reduce the inflammation around our herniated disc, this will reduce the pain. It’s like taking Voltaren, but without all the bad side affects.

So, the question is how did I even know foods could give an anti-inflammatory affect?

Over the last 12 months, I’ve noticed that after eating certain foods the pain running down my leg (from my herniated disc) was much worse than it usually is. I’ve also noticed after a booze up (some serious alcoholic consumption) that my pain was worse… Although I’m not sure if it’s from the alcohol, or the dodgy kebab and other crap I ate while I was pissed (drunk, sorry Aussie slang is coming out all over the place).

(As I wrote that last sentence, I hear people thinking “his pain can’t be that bad if he’s out on the town partying it up”… I can assure you that going out with me is a real pain in the ass for those that accompany me. I can’t stand in a queue at the bar, I can’t stand anywhere for that matter, I need to sit, and it needs to have a back rest. If there are a lot of stairs around the place then that’s difficult as well. When your missus (partner/girlfriend/wife) wants to dance it’s also a problem, basically I don’t/can’t. If the pub/bar/club is really busy, then seating can be a massive problem.. because the seats are already taken and people don’t want to give up a seat for you and your friends… I find most people will usually give me a seat… ie move along the bench or whatever.. but I end up out of the action and conversations.. hence I have a tendency to drink hard and fast. Okay enough of this tangent).

So, I’ve noticed that some foods (and some drinks) can increase my pain after I’ve eaten it.

Well I’ve done some Googling, visited the local library, and yes it’s true. There are foods and drinks that have an anti-inflammatory affect, and there are others that have an inflammation affect.

So, the next question is what foods should I avoid, and what should I eat more of.

Well from the reading I’ve done, it’s the usual stuff.

Fatty foods inflame.
Natural fresh foods can reduce inflammation (although not all).

I know it was at this stage, I thought… this is the answer to everything.
If you’re fat, if you’re unhealthy, if you’ve got some sort of condition.. the answers are all the same; Less fat, more green/fresh stuff. Sorry, another tangent.

So here’s a list I’ve got, I’ve tested, and it works:

Bad foods that can cause or increase inflammation:
Potatoes (doh! french fries are worse because of the oil)
Tomatoes
Red meats – especially fatty ones
High fat milk
Coffee
Margarine/Butter
Deep fried food (any time really)
Soda (the water part is good, but the acid and sugar bit isn’t good).
Apples (I’m not 100% on this one, but I think I notice an affect)
Salami – the bad oils in this one kill me!
Pizza – probably the tomato paste, oil, salami.
Smoking – not really a food, but makes a difference (the boozy nights I smoke).

Good foods that can have an anti-inflammatory affect:
Omega-3 essential fatty acids (fish, walnuts, supplements etc)
Olive oil
Fresh ginger (I try to get a bit of this every day)
Protein rich – tofu, soy milk, replacements etc.
Low fat milk (keep it to a minimal though)
Lots of water or 100% fruit juice
Chili
Green tea – this stuff is what I use to combat the bad stuff (if I was naughty)
Capsicum (Bell Peppers for our American friends)
Bok Choy
Broccoli
Cabbage
Cauliflower
Fennel Bulb
Garlic
Green Beans
Green Onions/Spring Onions
Leeks
Olives
Spinach
Blueberries
Blackberries
Strawberries
Raspberries
Almost anything anti-oxidant is really good

That is a reasonable list that I’ve tried and tested, it’s pretty hard to spot the difference in 1 or 2 things, but if you add up what you eat in a day and look at how much of it is in the bad list you can see where the difference comes in.

A few tips to follow:
Breakfast: oatmeal served with fresh fruit and walnuts and a cup of soy milk and a green tea
Snacks: whole fruits, nuts, seeds, and fresh vegetables throughout the day instead of cookies and candy.
Lunch/Dinner: Eat more fish and less fatty red meat. Stay away from deep fried foods.
Lunch/Dinner: Choose green, orange, and yellow vegetables for your side dishes. Bake & stir fry is best!
Drinks: Plenty of water, fresh 100 percent fruit and vegetable juices, herbal teas and green tea.

So, I review this list, and I think sh!t… that’s all the good stuff in the bad list, and all the crap stuff in the good list. How do I get around this..! I’ve found this works really well… If I’m going to binge, make sure you have a few things from the good list (I basically always go a massive cup of green tea which seems to have a really positive affect).

I’ve also found that the timing of when I eat makes a difference, for instance if I skip breakfast I generally find I’m worse off… I’m not 100% why this is.. but it makes a difference. If I eat dinner late in the night I’m worse off (again maybe why I get more pain after a booze up?).

If you’re interested in giving this a try.. and see if it makes a difference for you, what I’d suggest is cutting out all the bad stuff for 3 weeks… and analyse the affect it has on your pain. I couldn’t notice a big difference, because it came on slow over the 3 weeks… so then I went and had a massive binge at McDonalds, and the next day I felt the difference (the pain was probably 3 fold worse). So I’d recommend that as a way to see if you notice a difference… be really good for 3 weeks, and then slam in a greasy, potato, soda, red meat meal and see what happens (I was surprised).

Here is some more reading on the whole area of diet and the anti-inflammatory affects:
http://findarticles.com/p/articles/mi_m0NAH/is_8_35/ai_n14919163
http://www.healthcastle.com/anti_inflammation_diet.shtml
http://www.metabolismadvice.com/anti_inflammatory_food/
http://nutrition.about.com/od/dietsformedicaldisorders/a/antiinflamfood.htm
http://www.drweil.com/drw/u/id/ART02012

A Cochrane review by Gibson & Waddell (2007) found that a discectomy could alleviate disc-related sciatic pain in specific patients quite quickly. Another common surgical intervention known as spinal fusion (whereby the bony material is joined together thus closing up the disc and joint space) can produce good results in around 80% of cases (Cluett, 2007). However there can be lingering pain and problems after a spinal fusion due to a change in the normal biomechanics of the spine.

One of the most exciting developments is the introduction of a “disc replacement”. This approach has only been performed in the last few years (Cluett, 2007), and is still considered to be experimental, with research being completed mainly in Europe (An & Juarez, 2007). The normal disc is replaced by a metal and plastic device that behaves as a normal disc would. The advantage of this approach is that unlike spinal fusion, normal biomechanics of the spine are preserved and fewer complications develop (Cluett, 2007).

Disc replacements are particularly effective for relieving pain associated with degenerative disc problems (an ageing disc) at L4/5 or L5/S1 when six months of conservative intervention has failed to improve symptoms (Holt & Majd, 2007). Research also suggests those with post-discectomy syndrome (continued back pain after surgery for a herniated disc) may benefit from a disc replacement (An & Juarez, 2007). As this is a new intervention, it is difficult to evaluate whether there are any longer term complications arising from a disc replacement (Cluett, 2007).The current selection criteria includes single level disc disease, strong bone composition and the absence of problems such as scoliosis and spondylolisthesis(Holt& Majd). Potential complications include damage and dislocation of the implant and infection. As with any artificial device, the disc may be prone to damage over time from wear and tear (An & Juarez).

If you have any other specific tops you want covered, drop a comment!

Consult your GP, specialist or physiotherapist for any personal advice. Already done so? Why not get another opinion? Many disc problems can be successfully treated.

Author: Natalie Szmerling B.Physio
Suite 4/75 Bay St Brighton, Victoria 3186 Australia
03 95306353
info@baysidetherapies.com.au
www.baysidetherapies.com.au
Read Natalie’s other articles here

This information is informative only and shouldn’t be used to diagnose or treat any ailment, disease [or anything else].

References:

An, H Juarez, K. Artificial Disc Replacement. Available from URL http://www.spineuniverse.com/displayarticle.php/article1671.html [Accessed 2007 August 17]

Cluett, J. Lumbar Disc Replacement. Available from URL http://orthopedics.about.com/cs/backpain/a/discreplacement.htm [Accessed 2007 August 17]

Gibson, A Waddell, G. Surgical Interventions For Lumbar Disc Prolapse: Updated Cochrane Review. Spine 2007; 32 (16): 1735-1747

Holt, R Majd, M. Disc Replacement Surgery. Available from URL www.spine-surgery.com [Accessed 2007 August 17]

Tags: l4, l5, herniated-disc, herniated, disc, l4-l5, bulging-disc, bulging, buldging, buldge, bulge, slipped-disc, slipped, l4l5, l4-5, ruptured, protrusion, protruded, slipped, slipped-dsic, treatments, treatment, replacement, disc-replacement, biomechanics, spondylolysthesis, spondylolisthesis, discectomy, degenerative

I’ve been thinking what else would I want from a website about bad backs & herniated discs? There are my personal experiences, there are the specialist articles and I’ve started throwing in the odd quirky post about some random back fact. There must be more!

The other day I was lying down with a tens machine on my lower back to ease some of the muscle pain (spasms), and I was starring at the label on the tens machine thinking what else would be good. And it hit me, how about a section on product reviews !

I’m thinking I’ll cover what they do, how they work, what brands there are etc, pricing, craftsmanship, and how well I thought they worked.

Here are some of the products/services I thought would be interesting to review:

Products:
Tens machines
Back braces
Lumbar rolls
Anti-inflammatory tables (Voltaren, Mobic etc)
Anti-inflammatory creams
Heat creams/rubs
Inverter tables/beds
Zero gravity chairs
Massaging devices
Any other type of gizmo you’ve seen (like back balls etc)

Services:
Types of massages
Types of treatments (Physio, Chiro, Pilates, Cox technique)
Physio traction

That’s all I can think of right now, but I thought I’d put it out there, and see if anyone was particularly interested in me reviewing something they had thought of using, but had held back because they believed it was BS (bullshit, which there are lots of).

So, if there is something you want reviewed, make SURE you add a comment to the blog, and I’ll see what I can do (no promises because some of it might be expensive, but I’ll try to haggle anything )

Thoughts, comments?

Cheers
Matt

Tags: herniated, disc, herniated-disc, l4-5, l4, l5, l4l5, bulging, disc, buldging, ruptured, prolapsed, bulging-disc, herniation, bad, back, back, pain, back-pain

PHYSIOTHERAPY
Physiotherapy uses a variety of techniques to assist recovery of a herniated disc. These interventions include massage, gentle mobilization, ultrasound and heat. Physiotherapists are experts at prescribing exercises and will teach those that will be beneficial. Many of these will be based on Pilates exercises.

CHIROPRACTIC
Chiropractors are well known for their ability to perform joint manipulations through the body. However, forceful manipulations are discouraged when a disc injury is suspected. Also, a chiropractor cannot “pop” a disc back in. Chiropractic treatment for disc injuries often involves traction of the lower back and pelvis. This is usually accomplished by a traction machine or a special bed. Chiropractors trained in Clinical Pilates may also teach special exercises to stabilize and support the back.

OSTEOPATHY
Osteopathy uses similar techniques to physiotherapists and chiropractors. For a disc injury, this would include mobilization, massage manipulation and exercise therapy. Osteopaths focus particularly on the inter-relationship between different body parts. For example, a disc injury may have been partly caused by a weakness in the hip and pelvis, and this will be thoroughly investigated by an osteopathic practitioner. Osteopaths also help to encourage blood flow and drainage of chemical irritants which can relieve pain.

MYOTHERAPY
Myotherapists are experts in the field of muscle and soft tissue (ligament, tendon, fascia) therapy. They focus their assessment on the palpation of different muscles to determine if there is a contribution from the myo (muscle) fascia (the thin sleeve of tissue that wraps around the muscle). Muscle spasm and tightness is very common in disc injuries, and can often refer pain into the leg. Myotherapists also utilize interventions such as ultrasound, TENS machines and cupping.

WHAT TREATMENT IS BEST?
As we are all unique individuals, what works for one person may not necessarily work with another. Of the treatments described, physiotherapy is widely recognized and accepted by western medicine. Chiropractic and Osteopathy are offshoots of western medicine dating back to the late 19th century but they are not overly supported by western medicine. Along with chiropractic and osteopathy, myotherapy is also considered a complementary health approach.

HOW DO I CHOOSE A THERAPIST?
Always choose a therapist that is registered with a professional body (such as the Australian Physiotherapy Association). It is important to find a therapist who really cares about you and your injury. Be wary of practitioners who refute the value of other interventions. All philosophies and sciences have something unique and valuable, and in a comprehensive treatment plan, this will be acknowledged by a competent therapist.

To get all our posts delivered hot off the press make sure you subscribe to our email posts.

Brighton Bay Physiotherapy
Suite 4/75 Bay St Brighton, Victoria, Australia.
03 9530 6353
http://www.baysidetherapies.com.au

While you are sleeping the discs in your back are absorbing moisture from the soft tissue surrounding them and the limited blood flow (oxygen) that surrounds them (again primarily from the soft tissue/muscle surrounding them, there is no direct blood supply to your discs). This has the effect of filling them up, kind of like getting a sponge, squeezing it, and while it is being squeezed put it in a bucket of water and release it. The sponge soaks up the water, in doing so it becomes bigger, same applies to the discs in your back.

If you are sitting or standing you are putting pressure on the discs in your back. During the day while you are doing load bearing activities your discs are essentially being squeezed from your upper body weight. This squeezing is like squeezing a sponge full of water, Which reduces the width of the disc. ie reduces your height.

I know this still sounds a bit strange, and your probably thinking the difference would be negligable, but this effect can modify your height between 1/4 inch up to 2 inches (depending on your age). For those on the metric system that is 0.64cm to 5.08cm. If you don’t believe me give it a go, measure yourself when you get up in the morning, and then again late at night. There will be a difference!

This ongoing effect over a lifetime can end up ’shrinking’ a person. As the fluids escape and refill everyday and night of your life your disc slowly loses its ability to absorb the fluids back in, hence some older people have lost significant stature and get sciatic leg pain (from more pressure on and around the nerves that run to your legs).

This is also the reason that many herniated disc sufferers complain of stronger back pain at night than in the morning, because towards the end of the day there is less space left for the nerve to move, which means more pressure, which means more pain.

It is this effect that gives patients a short period of relief when using inverter beds, traction & the cox technique, however these techniques have also shown that the sustained negative pressure being created inside the disc (from hanging upside down, or being pulled apart) can actually ’suck’ the protruding disc material back in… so there are other forces at play.

Interesting!

If you or someone you care for is due for back surgery on a herniated disc, then this may be the most important letter you ever read.

Here’s why…

Going straight in for back surgery on a herniated disc without taking some crucial steps to prepare can increase the already inherent risks of such surgery on general health.

Physiotherapy
Physiotherapists are experts at assessing and treating disorders of the spine. Getting professional help early can dramatically reduce your recovery time and get you back to work and sport more quickly. You will receive advice on exercises and movements to avoid, as well as those that encourage healing. Many physiotherapists are experienced at teaching pilates and can design a program to strengthen your back and prevent further injury in the future.

Pilates
While it may be the latest fashion in sports and exercise, there is real benefit to be found from Pilates. Pilates exercises are based on improving posture and strengthening the “core” muscles. Whenever there is an injury or pain in the lower back, the core muscles reflexively “switch off”; Pilates can help to “switch on” your core again after injury. A strong core will provide crucial support and reinforcement to the lower back. Make sure you participate in a Clinical Pilates class that is run by an experienced physiotherapist.

Heat pack
Physiotherapists will frequently recommend the use of heat packs as a self management strategy. Heat packs are a wonderful and simple pain relief device that have been used successfully for thousands of years. The application of heat will assist in reducing or blocking pain sensations to your brain and will also encourage tight muscles to relax. This will leave you with more movement and less pain.

Anti inflammatory medication
The natural response of the human body to any injury is the release of inflammatory cells. These irritate pain receptors in the injured area and create discomfort. Anti-inflammatory medication effectively blocks the pain receptors and decreases the pain sensation. They are especially useful if you are experiencing pain during the night. If you are asthmatic, suffer from stomach ulcers or are pregnant, check with your doctor before using anti-inflammatory medication.

Back brace
A brace can help to provide extra support to your back while it is recovering. It essentially provides the same kind of support your core muscles would provide when they are strong and functioning correctly. Many people report and immediate improvement on using a back brace.

Walking
Walking is a wonderful, low impact activity that can help to maintain fitness throughout your life. It is also excellent for your lower back. The movement of your legs encourages gentle movement of the pelvis and spine, thus reducing stiffness. Being in a standing position can also reduce the loads and forces on the disc, thereby encouraging healing and decreasing pain.

Get a few opinions
Have you really tried everything? Surgery of any sort always involves calculated risks that you must be fully aware of. Spinal surgery in particular can be risky, and a positive outcome is not always achieved. Be sure to try a number of conservative treatments (physiotherapy, osteopathy, chiropractic, acupuncture) before you decide to walk down the path of surgery. For the majority, surgery can provide some relief but the degree of improvement varies from person to person. There are also cases of chronic pain that develop and persist after spinal surgery.

McKenzie Exercises
Robyn McKenzie is a physiotherapist from New Zealand who developed a system of assessing and treating spinal problems, including disc injuries. Her exercises and advice are based on positions and movements that encourage appropriate “re-positioning” of the disc fragments. Once the disc is sitting in its correct position, it will not be painfully impinging on nerves and tissues around the spine.. Many physiotherapists are skilled in McKenzie therapy.

Hydrotherapy
Combining exercise in a warm environment where there is no gravity can be absolutely superb in relieving pain and improving your mobility. Hydrotherapy is an excellent place to begin rehabilitation exercises.

Avoid activities that irritate herniated discs
Whenever we “herniate” or “bulge” a disc, it is usually displaced either backwards or backwards and to the side. The following activities and positions can really irritate a disc problem:
Sitting
Bending towards your toes
Bending forwards and twisting at the same time
Lifting
Driving long distances
Yard work
Gardening

The following can help to relieve pain and pressure on an injured disc
Laying on your tummy
Standing up
Walking
McKenzie exercises
Pilates exercises with an “extension” bias (ask your pilates instructor or physiotherapist for more information).

In my experience as a physiotherapist, I have seen the majority of disc injury patients make an excellent recovery using the above conservative approaches. This article does not substitute professional advice and treatment. For those residing in Bayside Melbourne Australia (Bentleigh, Hampton, Caulfield, Brighton, Elwood) and surrounding Melbourne suburbs, you can visit us here at www.baysidetherapies.com.au.

Others can find an APA accredited physiotherapist here www.apa.advsol.com.au.

Author: Natalie Szmerling – Physiotherapist & Pilates Instructor @ Brighton Bay Physiotherapy www.baysidetherapies.com.au

Address: Suite 4/75 Bay St Brighton, Victoria, Australia
Phone: 03 9530 6353

Disclaimer: This information is informative only and shouldn’t be used to diagnose or treat any disease, condition, ailment or anything else. Always consult your doctor or physiotherapist for personal advice and treatment.

Tags: l4, l5, herniated-disc, herniated, disc, l4-l5, bulging-disc, bulging, buldging, buldge, bulge, slipped-disc, slipped, l4l5, l4-5

There are lots of medical websites out there that explain what it is, and usually they are pushing some miracle cure or are sterile and void of understanding of what it’s really like to have a herniated disc.

I hope what I’ve written so far helps people move along the journey of dealing with the pain of a herniated disc, and NOBODY knows what it’s like unless they’ve had it.

Well I’ve spent a lot of time researching the topic, and I’ve included links on this site to information sources I thought were important.

However there are many questions I have asked along the way, yet they’re hard to articulate an answer for, and coming from me, well again I’m a patient, not a doctor.

I’ve gone searching for quality information to all the questions I had along the way, and we’ll be having a number of experts from all fields answer these questions in an easy to read manner that gives practical advice… the cool thing is these are real experts who deal with patients like us every day, which means if you like the advice they’ve given then you too can make contact with them and seek the treatment you need and deserve.

So if you haven’t already signed up for our email alerts for new posts then there is no time better than now because the expert tips are going to come rolling in.

If you have any questions you want answered post a comment to this post and we’ll see what we can do.

Lastly we’ll see if any of our contributors will offer the Bad Back Blog readers a discount for their first visit etc… so again another great reason to sign up for our email alerts.

Enjoy, and may your back be better.

Cheers
Bad Back Blog Team

Tags: herniated, disc, buldging, disc, bulging, disc, faq, herniated-disc-faq, l3, l4, herniated, disc, l3l4-herniated-disc, ruptured, disc, ruptured-disc

1. Do all these names mean the same thing?

Herniated Disc, Bulging Disc, Slipped Disc, Ruptured Disc, Pinched Nerve, Disc protrusion, disc extrusion.

In short, they’re all pretty much the same. Obviously some situations are different, but as a rule of thumb if someone says they’ve got one of the above, then there’s a 99% chance we’re all talking about the same thing. The primary differences are how bad the bulge is, has it ruptured, or is still disc material all contained within the disk annulus.

2. What is a herniated disc?
A herniated disc occurs when the inner substance of the disc called the nucleus is pushed out of the inner capsules of the disc. A herniation can then push into the spinal canal through a tear or rupture in the annulus. If you look at the disc as a round dinner plate, then a herniation/bulge makes the dinner plate go from a round shape, into a round shape with a bulging part pushing out of one side of it. It is this bulge (or protrusion) of the disc material that can push on the spinal nerve to produce pain. The pain normally manifests itself as leg pain (or commonly known as sciatica).

Disc herniations are a common cause of low back pain and leg pain (sciatica). Symptoms may include dull or sharp pain, muscle spasm or cramping, sciatica, and leg weakness or loss of leg function. Sneezing, coughing, or bending over usually intensifies the pain. A herniation may develop suddenly or gradually over weeks or months.

3. Why did it happen to me?
Herniated discs seem to occur more frequently in people aged between 30 adn 40. When you’re younger the disc is pretty flexible, but as you approach your 30’s and 40’s the affects of air pollution, smoking, drinking, aging all start to degrade the quality of the disc. It starts to harden. Imagine a marshmallow that you leave sitting in the sun. The outside will start to go hard and possibly crack, but the inside will remain soft for some time. When I say some time I’m referring to your 30’s and 40’s, which is the period people are most vulnerable. The cracks can form in the disc, or they’re more easily teared. The soft jelly inside can squeeze out and create a bulge/herniation. As you age over 40 the inside material starts to harden more like the outside, and it becomes much harder for the inner disc material to squeeze through a crack or tear…. so basically as you age and the disc becomes harder you’re actually safer from getting a herniated disc.

Now with that explained, you can imagine if you lift something heavy, fall flat on your bum, then it’s like squeezing the outside of the marshmallow, and if you’re unlucky the inner disc material will squeeze out.

Most people tend to herniate their disc with either lifting or falling on their bums… by this I mean they are on a jetski, or motorbike, hit a large wave/jump the seat of their vehicle hits them in the bum, and replicates the same action as someone slipping over and landing on their butt. So almost all disc herniations can be explained like this.

4. What should I do if I suspect I have a bulging or herniated disc?

5. What non-surgical options do I have?

6. What surgical options do I have?

This is a work in progress and I’ll fill it out before the end of August 2007, please let me know if you have questions you think are common that I’ve missed.

Okay, my thoughts on Piriformis Syndrome (which is what I was diagnosed with).

I think that I’ve had a disc rupture, it’s applied pressure to the nerve, and for months it was out of control… hence the epidurals etc. The spasims in my lower back, bum, and leg were basically left un-treated…. well I was using some anti inflammatories etc, but not much else.

I also admit that in the early days it was much worse, and I think much worse because there was more pressure on the nerve than there is today.

So I think over time, my body has slow reduced the size of the bulge. I think that part of that is to do with the cox technique (coxtechnic.com).
I think some of it was from getting moving again, pilates etc.

I think some of it is luck.

Now that the bulge has reduced in size (confirmed in MRI) the anti-inflammatories make much more of a difference.

So, I think the piriformis I was diagnosed with was wrong, I don’t think it was the root cause, I think that those muscles etc were very tight, and contributed to the pain, and when I started stretching and getting some relief, I was just relieving those muscles… I was much more comfortable I must admit.. but still, if I stand for 5 – 15 minutes, I’m in pain, and to me that’s pressure on the nerve from the disc…

I’d said in an earlier post that I’d gotten off of them (anti inflammatories).. we’ll I’m back on.. not all the time, but after a big night out, or after a day where I’ve been moving a lot.

I’m still restricted in my walking.. I’m thinking it’s probably around 8 – 10 minutes.. then I have to sit, or squat… only for about 30 seconds, and away I go again.

I rarely get spasims in my back, but when I do I get good relief from heat & ice packs… and a massage with some of that oil that get’s really

hot (axe oil, goanna oil etc) remember if you’re in acute pain, don’t use the heat, just the cold packs. Heat inflames the nerve more, and increases the pain.

I have no real pain sitting at work or at home, although if the chair is at the wrong angle, it just seems to put extra pressure on the nerve and I become very uncomfortable very fast (usually pain down the leg, and in the foot).. I figure this out very quickly and move to a different chair or position to alleviate the pain.

I definitely have times where I’m doing something, and I think for a second that I’m normal.. but usually there is some pain coming… this is why I’m considering the operation… I have come to the conclusion that you can put this off for years and years… and go nowhere.

Why waste another year of my life in pain… do all the research you can, make a choice, and get the operation done…for anyone reading this in a small town etc.. don’t let anyone operate on you that doesn’t do this particular type of surgery every day of week.. if they don’t do this operation ‘all’ the time, walk away.

It’s your back, and if they screw it up, you’ll suffer for the rest of your life.

That’s not to say if you get it done in a ‘big’ town you’ll be safe, but at least find someone who does it all the time, and ask for their statistics, if they refuse, chances are the stats are bad.. if the stats are good they’ll tell you.. that’s been my experience.

I have given up the pilates, and physio.. I continue to use a cox technic bed once a week, which seems to keep me in check… I can tell if I don’t go.

The anti inflammatories i’m back on are just Voltaren 25 rapids, although I must admit they still give me ‘issues’ in the stomach…. but compared to the back and leg pain… I put up with it.

I’m off of the walking cane, and get around pretty easy for short stints.. if it’s a longer stint like shopping I tend to cope if I have a shopping trolley to lean on…… that’s the coping strategy anyway, again, it’s not a way to live.. hence why I’m intending on having the operation.

If anyone’s got any other good tips about the operation side, let me know.

Cheers.

Tags: L4-L5, herniated, piriformis, syndrome, ruptured, sciatic, leg, back, pain, sciatica, disc, hernation, disk, buldging, bulging, disc

http://www.mylifemytravel.com/wolff/herniated-disc-2/

Tags: L4-L5, herniated, disc, bulging, piriformis, syndrome, ruptured, disc, sciatic, leg, pain, back, pain, sciatica, disc, hernation, disk, buldging

Well I’ll start from the last post.

I managed to get my walking up to approximately 30 minutes, which required a lot of effort.

Then in early November I went for a walk and the pain in my ass, calf, and foot was pretty extreme after about 5 minutes of walking.

This hasn’t really improved, and now in March of 2007 I’m still restricted to 5 minute walks.

I can actually walk a lot longer, but all of it has to be in 5 minute stints.

So I walk for 5 minutes, then either have to squat or sit for about 30 seconds to a minute and away I go again for another 5 minutes.

So obviously this is extremely limiting and a real pain in the ass. So I’ve started seeing more doctors because my current back Dr wants to operate.

The latest 2 doctors I’ve been to have both now diagnosed me with Piriformis Syndrome.

So Piriformis Syndrome (from my research) happens to runners and bike riders normally, both of which I’m not… however I found out that if you sit for prolonged periods (like 20+ hours) you can get the same symptoms (which is a tightening of the piriformis muscle, to the point where it starts to cut into the sciatic nerve, and gives the exact same symptoms as a buldging disc… most of the piriformis website explain that piriformis syndrome is commonly misdiagnosed as a buldging disc).

This whole life changing issue began when I drove for about 30 hours straight the easter of 2006… so yes, this has now taken me out to almost 12 months of life changing leg and ass pain.. doh!

So, if you’ve read my other blog posts you’d have read the epidural did help me, which would lead you to believe I really did have a disc problem and not piriformis syndrome. Well at the same time they administered a muscle relaxant.. so the piriformis muscle relaxed and so did the pain.

Also, I’d previously mentioned my CT-Scan and MRI both showed a buldging disc… they now think it’s a red herring and that I’d probably always had the bulding disc and that it’s actually not the source of any pain (something like 20-40% of the population have a buldging disc without any pain).

So how do you treat piriformis syndrome… you stretch it. Basically you can do it sitting or lying, I seem to get more pain when lying which would indicate it’s getting a better stretch.

Google search piriformis for the exact stretch, but in a nutshell, while lying in bed on your back, bend your knees with you feet still on the bed. Get your bad leg (in my case the left leg) and cross it over your right knee. So basically you put your left ankle onto your right knee.

Then you grab your right leg with both hands (if possible, I couldn’t at the start) and pull it towards your chest… initially I could barely get my left leg onto my right leg. Now I can get it on and pull it maybe 5 – 10cm’s to my chest…

If I swap and put my right leg on my left leg, and pull my left leg towards my chest it is uninhibited and comes to my chest pretty easily.

So far what I’m noticing is that my walking time hasn’t increased, however, the 5 minute period is a lot more pain free. So for 5 minutes I’m pretty good (not much pain) but as soon as it gets nearer the 5 minute mark I start getting the same pains.

The Dr’s explain that it’s a good sign, and to keep stretching. They’ve said some people are ‘cured’ within a month of stretching, and others it takes 6 months… the key is that you see positive results when you start the stretches… if you don’t then it’s not your piriformis muscle.

So, if it is a muscle then you can change the treatment, basically I’m doing a lot more general stretching, I’m taking natural muscle relaxants etc… (like bio magnesium).

I’ve also just seen a new Doctor, who I think is from a background of physiotheraphy, but he uses accupunture etc to relieve the muscle tension and pain.

He also said that many long term piriformis syndrome sufferers have usually have something else mechanically that is out of whack.

So what he meant by that was one leg shorter than the other etc.

He measured me up and said that my left leg was slightly shorter, but didn’t believe I was like that before. He believes the time I had off of work and in bed for months meant the muscles in my left foot and leg were significantly weakened and lost.

So he examined my left foot, and basically decided that my arch had dropped and that I was rolling over on my ankle. He has strapped my foot to stop it rolling inwards, which he believes gives me a centermeter or 2 in height in my left leg, which should also relieve some of the ongoing pressure on the nerve.

He has also given me these small thumb tack type needle thingys… basically imagine a thumb tack with some sticky tape across the back of it. He then placed it in a few key spots on my back and bum cheeks.

The idea here is to send the brain nerve stimulations from the general area where he believes the source of pain is coming from. The brain realises that the pain isn’t significant and starts to ignore the pain, and it should significantly reduce the pain in my leg.. we’ll see. I’m obviously a sceptic who prefers my money in my pocket than someone elses, but I’m prepared to give this guy 3 or 4 visits to let him weave his magic.. he came highly recommended.

He has also shown my partner how to do all the strapping and needle stuff, so that we don’t have to revisit for that stuff.

The recommendation from him and from his other patients is if he can’t get you better within a few visits he’ll refer you on… ie he won’t keep leeching the cash from you when he knows he’s not going anywhere.. which I think is pretty cool.. the industry itself is pretty shit at people who sell snake oils etc and recommend long term treatments a few times of week… basically I think in general these people are full of it and really are snake oil sales men.

So that’s pretty much it. I’ll endeavour to keep you updated on what happens with the new diagnosis and treatment.. but if I’m better I’m not sure you could hold me down long enough to type another blog post

Cheers

Tags: L4-L5, herniated, disc, buldging, piriformis, syndrome, ruptured, disc, sciatic, leg, pain, back, pain, sciatica, disc, hernation, disk, buldging

The progress has been slow, but at least there has been positive progress.

I think I mentioned earlier that life is managable, but still a pain in the ass (literally).

I’m still going to traction (flexion distraction) but only 2 days a week.

Physio and the massage has stopped as they believe they’ve done all they can. The massages were nice while they lasted

The latest thing I’m trying which seems to be working is Pilates.

I think the secret here is to have a tailored program where the specialist is in contact with the pilates instructor… in my case I’ve got a pilates instructor who only works with disc injury patients, so she knows to never put a patient into any postion regarded as ‘extension’… basically extension is achieved when you arch backwards… so an example would be standing up and leaning (arching) backwards…. basically this just pinchs the nerve and creates more problems.

Over the weekend I managed to do some gardening, 3 or 4 hours worth, and I’m paying the price at the moment, but it’s not how you’d expect…. my left leg is killing me, but not from referred nerve pain, basically it’s muscular.. it’s the most ‘exercise’ I’ve had in about 4 or 5 months.

In a previous post I said I was quitting the smokes… that hasn’t really gone to plan, but it is reduced consumption with a view to going to zero.

I’ve recently been asked if I’d be interested in going to the US for work for a 7 – 8 month stint, however I do have some concerns with my back… it’ll be interesting to see how that one pans out.

Back to my back, I’ve stopped icing regularly however I can’t knock the anti-inflammatories..

I’ve tried getting off of them slowly but generally huge amounts of pain come back, again it’s a see how it goes, and monitor the blood pressure.. apparently they can screw up your blood pressure if taken for long periods… I tihnk I’ve been on them solid for about 3 months now.

The walking cane has almost gone, but I have to drag it out every now and then..

That’s it for now.

Cheers.

I had my partner take a dodgy camera phone photo of me getting my pelvis re-aligned. It just so happens this is also on the cox technique bed….. The pevlis ‘adjustment’ is the blocks, you can see a square under my leg, and a larger flat panel under my stomach. For more info about the pevlis re-alignment, and cox technique read the previous post.

When the cox technique is in full swing there is a certified operator who stands on one side of you, placing their hand on your back (usually around the area of the rupture/herniation/bulge) pushing up towards your head, and at the same time with their other hand they push the table down at your feet end. So basically you’re being bent over forwards, except the key point is you’re being bent and pulled apart directly where your buldging disc is. It’s different to just bending at the waist, and it’s pretty hard to achieve the same result at home, it’s also different to the traction performed by a physio.

Some people who practice the cox technique also have machine operated beds. They lie you down how I am pictured above (less the blocks etc), turn it on, and you start going up and down around the area of your rupture/buldge/herniation. You should have some form of heat and some form of tense machine running while this is going on… mainly just for comfort reasons… I liked it anyway.

This goes on for about 15 minutes, and you concentrate on your breathing and relaxing the lower half of your back (easiest way to relax lower muscles in back is to breath in through the nose and out through the mouth.. seriously it worked for me). After 15 minutes or so the operator should return and do between 5 and 20 minutes of manual work (ie no machine involved).

Sometimes if it has been a long session expect some serious pain when you stand up. The reason is your nerve has been stretched, all the pressure has been taken off the nerve and disc, and standing up puts it all back on again… it should wear off in a few minutes of walking around the room… lastly if it ain’t comfortable don’t do it! For me it was always a very nice sensation, the operator should be gentle, and it shouldn’t be a jerky action… that’s it. !

Again, the cox technique has been one of the only ways to get instant release from the herniated disc pain that runs through my bum, leg, calf etc.

Tags: l4, l5, herniated, disc, bulging, disc, ruptured, disc, epidural, back, surgery, flexion, distraction, cox, technique

I’ve had some significant improvement… from its worst I’d rate my improvement somewhere around a 70% improvement, and I’m now almost off all drugs. The only drug I’m taking is an anti-inflammatory (Mobic 15mg, only one that doesn’t upset my stomach).

Some interesting things I’ve found out along the way:

1. Valium should only be taken at night, and you want to get off it asap. If you take it during the day and try to move/walk you’re doing yourself more damage. The Valium is a muscle relaxant, so walking around with relaxed muscles sounds good, but the the spine needs the muscular support to stop more damage being done to the disc. The muscles are required to keep everything in place and keep as much pressure off of the disc as possible when sitting, standing, walking etc. So if you have to take the Valium only at night, and when you take it make sure you’re settled in bed for the night.

2. No one person holds all the answers. If you have a herniated disc you’ll be told so many things to do, and what worked for others….. listen to your body, and if something hurts don’t do it. Normally you’d expect that the saying no pain no gain applies, but it doesn’t. Pain means you’re inflaming your nerve, which takes days to settle down. I’ve seen more than 5 GP’s and each one had a different thought on what I should do, ranging from bed rest for weeks on end, to exercising and walking as much as possible, in my case I ultimately sat in the middle. Much of it was bed rest, but exercises that didn’t cause pain were also worth it.

3. Most physio’s have got the wrong end of the stick, they get you to do exercises that put more pressure on the nerve, not less. For instance in my most acute phase I had a physio show me an exercise that created significant pain, but I was told it was the standard exercise for ruptured/herniated discs. The exercise was on your knees and hands, and arch your back up, and then push down (so arching your stomach up, and then pushing it to the floor). It looks like you’re doing a cat stretch, arching your back right up, and then right down.

I found the going up part (arching up) felt good, but going down extremely painful, and my research so far is that going up distracts the vertebrae (ie doesn’t pinch the disc), arching down pinches the disc and puts more pressure on the nerve. As I said anything that hurts the nerve more is bad, it takes days for the inflammation from a bad exercise to go down.

4. Ultimately if you can make it through the pain using meds, I think a large portion of people will get better of their own accord.

5. See a chiropractor who works with disc patients all the time. I wouldn’t let any chiropractor crack me and if they said the word adjustment I’d leave. The 1 thing that gave me the biggest single improvement was having my pelvis (for lack of a better word) adjusted…. the adjustment did not require being cracked etc, the chiro simply places small blocks under your hips/pelvis/legs and leaves you to breath and relax, and your own weight over the top of the blocks puts your pelvis back in… I’m not saying people with a disc problem have an out of alignment pelvis, but it’s worth seeing a chiropractor to see if your back is out, because in my case my pelvis was out and was putting even more pressure on the disc. My main comment here is if you feel comfortable with the chiropractor, and they take it slowly then it’s at least worth the visit to rule that out as a possible contributor to your pain. I also found the chiropractor forced me to take x-rays, which I hadn’t had, I’d only had a CAT scan and an MRI, but the basic x-ray showed I also had an antalgic lean, a few basic exercises for the antalgic lean also gave me a huge improvement.

6. I saw a neurosurgeon and an orthopedic surgeon, both very competent. Make sure your orthopedic surgeon only specialises in lower back pain. If he does other things he not a specialist. Both of these professionals were good at explaining what was wrong, but also advised me of not using alternate therapies because it would do more damage. I initially took that advice, but after a while decided to give alternate therapies a go… I figured if I felt I was being pushed or I wasn’t comfortable with what they were doing I’d say so, and walk out. One big thing I think anyone suffering from disc bulging/herniation/rupture should try is flexion distraction (or the cox technique). I was very sceptical, and I made sure they took things very slowly. For certified practitioners check here http://www.coxtechnic.com/. It’s worth a shot, and It’s done wonders for me.

7. Get a lumbar belt/support and don’t take it off except for showering. Sleep in it. I was soooo surprised when I got one and spent the first day in it.

8. Get a massage every day if you can. I had severe muscle pain in my left leg. Thigh, left buttock, and lower back. I saw a physio who did massage, and it seriously is what has got me through each day. My bank account doesn’t love me, but seriously I was surprised at the effects. Maybe it doesn’t have to be daily, but maybe every 2 or 3 days, and get your partner/family member to come a long and watch, the massage technique should be simple and not too hard. Having a family member watch and do it to you at home morning and night was an absolute life saver for me.

9. Returning to work is high on my list of priorities….. 2 months of lying around in bed does your mind in, so getting back to work is a mind saver. I attempted to go to work too early and lasted about 4 hours, and the last 2 hours was nasty pain. That premature start set me back at least a week. I now have a structured plan for returning to work which I trialled at home first. I started on Monday with 2 hours of sitting (not continual but get up every 20 minutes for a small walk), the same on Wed and the same on Friday. I did that at home and could see I was recovering fast enough. I spoke to work and got them on board with my plan, expectations were set and everything so far is going smoothly.

I hope I can get my hours up every day I go back (maybe just 15 every time I go). I judge how I’m going by the recovery time. If the next day I’m so sore I can’t move properly then it means you’ve done too much, back it off immediately. The reason I stress the structured return is because people who haven’ had a disc problem just assume you’ll be better when you come back, and you’ll sit down and do a full days work, this is not the case, it will take time to rehabilitate and get your body back to where you were. Remember I had 2 months of almost solid bed rest, so I had lost a lot of core muscle (ie back muscle, leg, basically everything).

10. Don’t wear slip on shoes…. I did because I couldn’t do my shoe laces up, but when I got laced shoes on my feet I walked a lot better. This is because with a slip on shoe you’re constantly walking differently with your toes trying to keep the shoe on. It’s not good. When I changed I got an immediate improvement in my walking ability.

11. This should be number one, but I forgot it. Always use ice and not heat when you’re really bad. Heat just inflames the area more. Never have a cold pack on your back for more than 10 minutes. After every icing make sure you stretch out your back muscles, otherwise you’ll feel like a cripple who’s muscles are so contracted you can’t move. The best exercise to stretch everything out for me was lying on my back, knees bent, and pulling my knees to my chest both at the same time.. honestly that was the best stretch for my back, and I think that exercise is reasonably universal… the reason being is that it distracts (takes pressure) off of your disc.

12. If you go out anywhere always make sure you have house keys, if you get massive pain you can always jump in a taxi on your own and go home. I’ve been caught out without keys and my partner, it’s not good with major pain and waiting on someone.

That’s pretty much it. I’ll add to it if I can think of anything else that’s helped me.

Feel free to leave comments, and I’ll reply if I can help.

Lastly don’t give up, I think the biggest positive about this condition is that over time it will heal itself, it’s just a question of how long, some people it’s weeks, other’s i can be 6 or 12 months…. I know it sounds a bit like how long is a piece of string, but honestly I think most people will just heal themselves, without drugs or any other medical intervention. The drugs just make it more comfortable.

Cheers

Previously I’ve had CT scans and an MRI, but on Tuesday I had an x-ray of my spine from front on, and from side on. The guy reckons he sees about 10 cases of my back in a year, and he estimates he sees around 300 – 400 new patients a year, which is an inverted lower lumbar. The small of my back is arching the wrong way.. don’t know why.

What makes my case even shitter than normal is that I also have the herniated disc pinching the nerve. As all the specialists have said the herniation is very small and shouldn’t be causing as much pain as it is, but this guy seems to think the combination of the small bulge and herniation with the inverted lower lumbar is giving me all this grief.

The x-rays looked pretty bad, the side on view showed how the arch was inverted, and the front on view showed how my spine skewed to the left. It skews to the left because the left side of the disc has collapsed and squirted out the disc material into the spinal cavity.

Anyhow, a combination of the drugs and the fact I’m not walking, not sitting and not sleeping very well is really starting to get to me and I’m starting to think screw it just have the surgery and be done with it.

I’m actually typing this sitting up and I’m trying to sit in a chair with a lumbar support (rolled up towel) and although I’ve got some pain in my calf generally I’d have to say it’s going okay, not sure if I’m ready for a full day at work yet, and there’s no way I could do it in a normal office chair.

Work is organising an occupational health and safety officer to visit me on Monday morning in the office to measure me up, buy me a chair, new desk if needed and get everything aligned at the right heights…. She’ll have to do it all very fast cause I can’t stand for more than 2 minutes, and I can’t sit for more than 2 minutes if I don’t have a chunk lumbar support…. basically I have to lie down on my side (either side works) and get into a huddled position knees to my chest, with a pillow in between… and wait until all the cramping stops. The shitty thing is that the cramping is coming from the nerve being compressed not from strenuous muscle activity, so no amount of rubbing or pushing in creams is effective (which seriously blows).

Anyhow, that’s pretty much it.

Tags: L4-L5, herniated, disc, bulging, disc, back, pain, herniation, L4, L5, epidural, injection

I’m about to start trying some exercises out of the book “Treat Your Own Back” written by Robin McKenzie. It turns out a friend from work loaned me the book when he saw my back getting bad, and that the website listed below also mentions the book and it’s usefulness, I’ll keep you posted on how it goes, and if I notice any improvement from the exercises.

Okay, for anyone following my back problems, I’ve found a website of someone who’s been through it, and the way they described their pain when it started and how it got progressively worse and even her issues with the doctors is exactly the same as mine.. worth a look:

www.mybacksolution.com

Basically she took the alternative therapy and said it’s my back and I’ll fix it, rather than going down the surgery route.

Tags: l4, l5, herniated, disc, bulging, disc, ruptured, disc, epidural, back, surgery

I should have mentioned this earlier, but for anyone with disc pain, to sleep you need many pillows. One between the legs, one under your foot, and I always needed one wedged behind my back and under my side, and on wedged infront under my chest.

But anyway I think either the epidural is finally shrinking the piece of disc material or my body is naturally starting to break it down and relieve the pressure off of the nerve.

Most of my @ss and theigh pain are subsiding, and I think I mentioned in the last post I’m left with a dull pain that comes in waves in my ankle and lower calf.

Walking is still a problem, but I feel now it’s the percentage of the problem has probably swung to lack of muscle in my theigh and calf.

I think I also previously mentioned my left leg has wasted to about half the size of my right leg, mainly from non use, and me protecting it as it caused huge pain if I moved it.

So I figure if I give it a few more days for the disc material to shrink and start working on my strength in my left leg I’ll probably get the walking thing happening.

Anyhow, feeling positive and drug free.

Tags: l4, l5, herniated, disc, bulging, disc, ruptured, disc, epidural

I’d have to say I’ve probably got an improvement of around 20%.

I think something has moved in my back and the pain has shifted from my left ass cheek and left leg thigh to my left calf and ankle.

I’ve been told I have got some nerve damage as my left big toe has lost about 80% of it’s strength when you try to lift it up (but at the end of the day they tell me that doesn’t really matter).

The pain has gone from strongh sharp pains to dull pains that wave in and out of the calf and ankle.

I guess with the reduction in sharp pains I’ve managed to significantly reduce the amount of pain killers I’ve been taking.

Trust me the Panadene Forte has some serious cement like action… if you know what I mean.

I feel if the current course of improvement continues I’ll probably be back at work in 2 – 3 weeks, and I’ve been told that disc injuries generally take 6 – 7 weeks to get recovery, but in bad cases can take up to 24 weeks to get back to normal without invasive treatment.

I guess I’m feeling a lot more positive about it as I’m seeing some improvements, I’m able to bend a lot easier and move around a lot more.

Walking and standing is still very painful and I couldn’t go more than 50 meters without having to sit or lie down.

Anyhow the I can see the light at the end of the tunnel now.

I wanted to speed the recovery process with exercises etc, but after talking to the back specialist (Gary Speck who is one of Australia’s best back orthopedic surgeons and world renouned) I’ve been told any exercises during an acute phase of disc herniation are not advised. He recommends nothing but bed rest and trying to just get up and move around throughout the day.

He went so far to say that seeing a physio or chiro in his mind would have the following results:
25% chance of improvement, 25% chance of no improvement, 50% chance of doing more damage…. so I take that as do nothing.

Tags: herniated, disc, bulging, disk, epidural, injection, l4, l5, disc, back, pain, lumbar, pain

I’ve just spent that last 4 days in hospital. In a previous post I said my back took a turn for the worst on Sunday night 11th of June.

Monday being a public holiday I still notified the specialist (Gary Speck) that my back condition had changed, and we decided to hold on and see if there was any improvement after the flare up and we’d meet to discuss the MRI result on Thursday. My back didn’t get any better, and probably got worse and worse. I had the local GP make a home visit and he prescribed some serious pain killers….

Thursday came and the only way I can get comfort is on my back, or on all 4’s. Couldn’t stand, sit walk…… So I crawled to the shower and got ready to go to the specialists. It a good 15 minutes and a serious amount of pain and cramping to make it the 15 meters to the car, where all I could do was stand on all 4’s on the back seat.

We parked illegally at the specialists and I made it to the front door on a stoll I took with me from home. The receiptionist helped me inside, but she tried to make me walk which put me in so much pain I could do nothing by cry and crawl inside.

The specialist took one look at me, reviewed my nerve function and said that my big toe was starting to lose power and that it was time to go to hospital and get the epidural.

I was in so much pain and upset that I just went with the flow.

The ladies in Gary’s office organised everything, within minutes I was at the hospital, in a wheel chair in a bed getting morphined up. For those intereseted they gave me 2 injections, morphine and ??????… These 2 injections would have to be the two most painful injections I’ve ever had in my life…. I screamed and cried so loud a bunch of nurses came from the hall to see what was going on… It was bad, and I’d suggest anyone who gets the choice to get the injection in the ass rather than the thigh… I still have a bruise and numbness in the leg.

They had also organised an anesthesiologist to come to the private hospital and I was the last patient of the day. I’d say I had my epidural injection around 6pm.

The anesthesiologist gave me the low down on everything, he explained the risks, the benefits etc. He said he did them daily and in the last 8 years of him doing them he’s had 2 where he’d ruptured the nerve casing which gives you a headache, but the odds were extremely low.

Basically they gave me a local anesthetic shot in the lower back which was reasonably painful but was over with pretty fast. He had me lying on my left side in a recovery style position with a nurse holding my legs and a nurse holding my upper body.

He pushed reasonably hard in and around my hips and spine with his hands and although I didn’t feel it he inserted a reasonably large needle, pushed it in, and loudly said to everyone “it’s in, and hold”. Probably held the position for about 15 or 20 seconds while they injected the fluid, and then it was over.

I was moved back off the operating table, and onto my bed, and rolled to a recovery area… where I pretty much fell asleep… I’m pretty sure they slipped in some sedative, although on the morphine I don’t remember a whole heap.

When I woke up back in the ward I could feel an instant change, which was the local anesthetic, but there is also a really weird warmth you feel down both legs. I had to lie face down with a slant to my left side, apparently the epidural has a settling period??? ie the left side being the bad side if I stayed on that side for 40 minutes after the injection then it would give a better benefit to that side.

I’d have to say so far that the injection has given me some relief and I’m not as bad I was before the injection, but then again I’m not moving around, I’m on huge amounts of pain relief.

I’ve now got a wait of around 10 days post injection to see if I’ll need surgery to get moving properly again. I’ve got an appointment this Friday where I’ll find out the future.

If the prognosis is an operation I’ll probably seek a second opinion although I’d have to say so far I don’t see how it’s going to get better.. something just feels broken/wrong and needs to be removed fixed. (if that makes sense).

Anyhow that’s pretty much it…. If anyone wants more info about what’s happened drop me a line.

Tags: l4, l5, herniated, disc, bulging, disc, ruptured, disc, epidural

The GP made a home visit (I’m sure the invoice is in the mail) last night to prescribe me some higher pain meds so I can try to make my way to the car at midday for my appointment with the orthopedic surgeon. As I said in a previous post, and from what the specialist has said over the phone it would appear an epidural shot to the back is ineviitable.

I find a good position is on all fours on the bed, and arching my back up and down seems to free me up enough to make a dash for the toilet. If I try to stand up or move without any stretching basically I cramp and cry on the spot…. it really is a terrible affliction.

It’s at this point I’d also like to point out that having to go through this on your own in life would be an absolute mess and a nightmare. Which I wouldn’t even wish on the very few ‘enemies’ in life that I have.

I’m extremely fortunate to have a partner who’s basically hiring me DVD’s, helps me up, rubs in creams, heats up heat pads, and remembers what time I’ve got to take medication (seriously, last night’s concoction would have put a rhinoceros to sleep). I honestly couldn’t get through this without help, and having someone who cares and shares the emotions with you makes a massive difference.

I’m reaching a point where I don’t have a comfortable position… it was on my side, left leg cocked, but now it’s on my back and I find myself moving every minute or so.

Other side effects of this back problem:

1. I’m on steriods to shrink the discs, so I find that I have amazing clarity of mind, and the valium at night makes sure I rest well. So I find the days extremely frustrating as I can’t move, can’t help out, can’t do anything… so it gets you thinking about other things.

For instance, business ideas is a big one…. You start thinking, right my back is screwed, but life goes on. What can I do to make money if I have no back function. I think I’ve come up with about 5 different business ideas that if I had to I’d put into place.

I’m also doing a lot of thinking about web based businesses, e-commerece, blogs etc. For instance I haven’t found a blog site for people with bad backs… the orthopedic surgeon who I’m seeing later today doesn’t even have a website… I think I’m going to offer to create him one for free, and each of his patients can have a blog that hang off of it.

I remember when I heard herniated disc L4 L5, the first thing I thought was ‘google it’.

I did, and I got shit scared. There are a lot of horror stories, but from everything I’ve gathered, up to 90% of herniated/ruptured discs heal themselves within 2 – 6 months.

Not so good when you’re in the middle of a career that’s just starting to boom and you’ve got 50+ direct reports waiting on you, but none-the-less there is meant to be light at the end of the tunnel, and that’s how I’m looking at it.

2. The other stuff you start thinking about is why me…. Have I been a bad person (which implies you believe in god), physically what have I done, what could I have done to prevent this etc etc.

I think for me I need to turn it into a life changing event. I probably carry an extra 15kg, which I’ve always known I had to lose, it’s just now there is more of an urgency, more of a reason… I seriously don’t want another herniated disc, EVER!

The problem now is that I have no mobility, my back feels terrible, and I’ve got to lose the weight.

My action plan is this:

1. Meet the orthopedic surgeon
2. Ask for some basic exercises to strengthen back and stomach muscles without doing more damage and placing more pressure on bad discs.
3. Get the epidural shot (there are some risks, which I’ll publish in a later blog).
4. Hope that I get mobility and can return to work.
5. Start a routine that allows me to etch away the weight. I’d like to say I’m going to binge and knock it all of in a few months, but I’ve done it before, and it never sticks, this has to be a longer term goal, that isn’t just to lose the weight, but includes the desire to travel, reduce the burden on my partner etc… if it was just a weight lose goal then I’d get there, and I’d ask the question what now, and probably start gaining again.
6. Take my partner to Manhattan NY where I visited with work a few years ago, and take my partner for a jog in and through central park, and along the water near the UN.

If I can achieve all of this within the next 12 months then that will be amazing, but I guess as the weeks progress by, you’ll find out how my epidural shot goes and what’s ahead.

PS: If anyone is carrying a few extra kilos out there, and thinks they’ve never had back problems before (like me) don’t dismiss this. I can happen and if/when it does you will curse yourself for being so stupid not to do something about it…. the pain, the burden, the thought of back surgery is sooo hard to cope with…

I guess the same applies for smoking and cancer, but it turns out I can’t stand/walk/sit so I can’t get outside for the smokes…. so in that sense, I’ve quit.

THE RISKS OF THE EPIDURAL:

Risks Associated with Spinal Injections
Spinal injections are minimal invasive medical procedures and therefore their potential risks associated. Generally, however, there are a few risks associated and fortunately they tend to be rare. Risks may include:

Infections. Minor infections occur in 1% to 2% of all injections. Severe infections are rare occurring in 0.1% to 0.01% of injections.
Bleeding. Bleeding is a rare complication and is more common for patients with underlying bleeding disorders.
Nerve damage. While extremely rare, nerve damage can occur from direct trauma from the needle, or secondarily from infection or bleeding.
Dural Puncture (“wet tap”) – A dural puncture occurs in 0.5% of injections. It may cause a post-dural puncture headache (also called a spinal headache) that usually gets better within a few days. Although rare, a blood patch may be necessary to alleviate the headache.

Tags: l4, l5, herniated, disc, bulging, disc, ruptured, disc, epidural